Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.29 / $120.65 / $129.13	Facility	26	$112.29	$120.65	$129.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $338.71 / $568.11	Professional		$171.00	$338.71	$568.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.43 / $80.79 / $322.75	Professional	26	$55.43	$80.79	$322.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $226.42 / $440.02	Professional	TC	$119.70	$226.42	$440.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.36 / $431.86 / $1,325.91	Professional		$169.36	$431.86	$1,325.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.15 / $133.50 / $439.54	Professional	26	$56.15	$133.50	$439.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.21 / $288.68 / $886.37	Professional	TC	$113.21	$288.68	$886.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.04 / $136.96 / $233.52	Professional		$64.04	$136.96	$233.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.38 / $176.91 / $235.13	Facility	26	$151.38	$176.91	$235.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.54 / $609.91 / $693.09	Professional		$247.54	$609.91	$693.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.56 / $202.30 / $229.89	Professional	26	$66.56	$202.30	$229.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.43 / $407.62 / $463.20	Professional	TC	$164.43	$407.62	$463.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $540.32 / $540.32 / $540.32	Facility	26	$540.32	$540.32	$540.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $227.24 / $570.38 / $1,882.38	Professional		$227.24	$570.38	$1,882.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $68.63 / $158.87 / $434.24	Professional	26	$68.63	$158.87	$434.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $155.07 / $419.99 / $1,906.00	Professional	TC	$155.07	$419.99	$1,906.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $130.87 / $312.33	Professional		$56.22	$130.87	$312.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $334.75 / $501.51 / $1,132.41	Professional		$334.75	$501.51	$1,132.41
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $137.43 / $540.32 / $540.32	Facility	26	$137.43	$540.32	$540.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $256.88 / $1,035.95 / $1,882.38	Professional		$256.88	$1,035.95	$1,882.38
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $85.20 / $300.70 / $434.24	Professional	26	$85.20	$300.70	$434.24
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $175.15 / $846.45 / $1,906.00	Professional	TC	$175.15	$846.45	$1,906.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $738.34 / $1,086.82 / $1,086.82	Professional		$738.34	$1,086.82	$1,086.82
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $201.29 / $212.42 / $328.88	Professional	26	$201.29	$212.42	$328.88
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $409.81 / $579.75 / $1,145.14	Professional	TC	$409.81	$579.75	$1,145.14
United Facility/Professional Professional Modifier Low / Median / High Price $207.72 / $469.64 / $882.56	Professional		$207.72	$469.64	$882.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.65 / $140.49 / $263.56	Professional	26	$65.65	$140.49	$263.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.41 / $341.37 / $695.20	Professional	TC	$139.41	$341.37	$695.20